Two years ago – 2008, my freshman year of college – I weighed nearly 200 pounds, but after apparently successfully dieting and cutting certain foods/liquids out of my life (namely soda/caffeine) and incorporating exercise into my routine, I now weigh nearly 155 pounds. Prior to my weight loss, I was miserable and self-conscious about my weight and appearance, but these results have boosted my confidence. This past semester (2010), however, I started forcing myself to vomit on occasion – beginning in February. I can’t remember how or why this started, but for the past four months, I feel on certain occasions when I eat more than 1200 calories that I am immediately becoming overweight and fat. I always count calories, and try to maintain a 1200-calorie diet. When I exercise (which was normally when I was at school) I primarily run (about 10 miles a week) but since my return home, I’ve fallen out of my routine and I’ve become very anxious about my physical activity – I feel like every moment I’m not moving, I’m developing muscular dystrophy. My vomiting as a result has become more frequent. As a result, I’m frequently light-headed, dizzy, lethargic, miserable, nervous, and lacking of an appetite. I’m trying to seek help for this, but I don’t know how to properly diagnose myself – and I’d like to understand what’s wrong first. Am I suffering from bulimia or anorexia nervosa? I don’t know if I’m bulimic because I’m told you need to vomit after every “big” meal, and sometimes I go days without vomiting. I’m also a guy, and I’m told eating disorders are more frequent in women, so this has me doubting and confused. Please help!
Thank you for writing us about your issue. Eating disorders run the gamut. While they have criteria that more specifically characterize one over another, it is not uncommon for a variety of symptoms to be present at different times. I can understand your confusion and hesitation. But you have described enough details here to indicate that the weight loss, change in routine, self-induced vomiting, lightheadedness, lethargy, nervousness, lack of appetite and dizziness are cause for concern.
Although you did not mention your height, it is very likely that your 1200-calorie count is too low to maintain without the help of a professional. You may want to enlist the help of a registered dietitian who can monitor your diet and make recommendations for balancing out your eating, exercise and nutrition. You can find direct help in your area from the American Dietetic Association.
You may also want to work with an eating disorders therapist (available at the top of the page under “find help”) to help with understanding the emotions often associated with eating disorders. I think with the right professional guidance you will be able to orchestrate a plan that allows for positive changes.
While it wouldn’t be possible to answer your question about a diagnosis for you, I do want to respond to your question about men and eating disorders, particularly anorexia. While estimates vary, men constitute five to 10 percent of the cases. Dennis Quaid, the famous actor, recently used the phrase “manorexia” when describing his bout with the disorder.
You have already demonstrated that you are very willing to work hard at bringing productive and sustainable change into your life. I hope this has been helpful.
Wishing you patience and peace,
Dr. Dan